Tuesday, May 11, 2004

Larry Davidson whose book Living Outside Mental Illness I have been reading the past few weeks describes the sort of value free assumption free research he attempts to do with his interview team. They are not looking for a grand theory or a predictive science.

Here is a quote about insight that is good and possible uplifting. Warning this effect will wear off in the company of clinical psychiatrists

From the section in chapter 4 entitled "I may be crazy, but I am not stupid"

In this way, schizophrenia appears to be similar to other illnesses that manifest certain signs and symptoms behaviorally without, or prior to, more internal changes. Unlike fever, in which the person feels hotter than usual, diabetes, for example, may at first be suggested through frequent urination but then is diagnosed through blood tests. Prior to experiencing what one comes to recognize as the effects of low blood sugar, there is no experience of diabetes per se. Even in cases in which the signs or symptoms of an illness maybe experienced subjectively as well as observed behaviorally, such as the difficulties in breathing characteristic of asthma, the person is not aware of the nature of the illness until these signs have been explained through a healthcare provider's assessment and diagnosis. The same appears to be true of psychosis; there is no definitive experience of psychosis per se from which a person might then infer independently "I am suffering from a psychotic disorder"
Is this what is meant by the lack of awareness of illness in schizophrenia? It would be unreasonable to describe people with schizophrenia as lacking insight just because they were unable to determine the nature of their disorder on their own......
[Larry Davidson, Living Outside Mental Illness: Qualitative Studies of Recovery in Schizophrenia (New York: New York University Press, 2003) p.133.]

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